First, the bad news. As I wrote previously, Grandpa's condition has worsened -- he has congestive heart failure, which means his heart is still working, but not well enough to provide the blood his organs need. The doctors said the best-case prognosis would be that he might be able to sit in a chair. We know that isn't the lifestyle he would want, so that made my mom's decision (everyone agreed, but she has power of attorney) pretty clear. They disconnected his feeding tube yesterday, so now it's just a matter of time, probably less than two weeks.
The next issue was what to do about hospice care. Everyone recommended an inpatient facility in Barrington as the best place he could go. There was only one problem: Medicare will only pay for a few days of inpatient hospice care if his condition is stabilized (meaning that his pain can be managed with drugs and he isn't "actively dying"). Then he would have to go to a nursing home (which he definitely does not want) or back to his house for in-home hospice care (which isn't viable for us for a number of reasons). Grandpa has been shuttled between facilities a few times this month, and being moved is very uncomfortable for him. We don't want him to be bothered with that again in his final days. We asked the nurse how much it would cost to keep him in the inpatient facility, and she didn't know. Their focus is so much on Medicare (and probably dealing with people who have no money) that cost is never discussed. I didn't think it would cost that much money (say, under $2K), but my family noted how expensive healthcare can be, with an overnight hospital stay costing tens of thousands.
Today we got some great news: it only costs $600 a day to keep him there. Since we know it will be for a finite length of time (even a healthy person wouldn't last long without food or water), it won't be any problem to keep him there regardless of Medicare coverage. My mom just called to say he's there now. It's a really nice, quiet place, and we know he'll be comfortable there for the rest of his time on Earth.